What Are The Challenges For Indonesia In Achieving Universal Health Coverage

1940 words - 8 pages

There are many reasons why countries put their effort towards universal health coverage. Universal health coverage is perceived as the assurance that all people will be able to access health services without experiencing financial difficulties (WHO, 2010). The World Health Organization (WHO) put this issue as one of the global health priorities since 2005, when a resolution on universal health coverage emerged during the 58th World Health Assembly (WHA) (World Health Assembly, 2005). Seven years later, global awareness of universal health coverage culminated when the Director-General of the WHO underlined the importance of it as "the most powerful concept that public health has to offer (Chan, 2012). In response, Indonesia made a significant effort by integrating several forms of health insurance already existing in the country into one scheme to be managed by a single body (Republic of Indonesia, 2011; Simmonds & Hort, 2013). The designated body established in 2012, called the Social Security Administrative Body, has been working under a framework aiming to achieve universal coverage by the end of 2019 (Republic of Indonesia, 2012; Republic of Indonesia, 2013).
There have been challenges identified in several publications for countries to reach universal health coverage (World Health Organization, 2010; Tangcharoensathien et al, 2011; Lagomarsino, Garabrant, Adyas, Muga and Otoo, 2012; National Development Planning Agency, 2012). High income countries faced challenges not only in terms of managing health finance during economic fluctuation, but also increased cost of health service (WHO, 2010). In low income countries in Southeast Asia, the main challenges would be the government capacity in financial management and also coverage expansion (Tangcharoensathien et al, 2011). Based on the WHO Report in 2010, middle income countries such as Indonesia are predicted to encounter challenges found in both high and low income countries while adding its own. This paper will focus on the main challenges faced by the Government of Indonesia (GoI) in achieving universal health coverage which are lack of government capacity in managing health finance, extending health insurance coverage, and establishing good governance in the decentralization system, and discuss recommendations.

The first main challenge for the GoI is health financing management capacity. Studies conducted in developing countries in Asia showed that good financing system will ensure quality of health care (Tangcharoensathien et al, 2011; Lagomarsino et al, 2012). In the case of Indonesia, the GoI is committed to improve health system and putting considerable effort towards universal coverage. However, allocation for health sector was less than 9% of the total government budget in 2010 (Tangcharoensathien et al, 2011) which was lower than Bhutan, Thailand, and Maldives (WHO, 2011). Furthermore, although the GoI claimed that the health sector expenditure has been increased twofold since...

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